EMCrit Podcast EMCrit 356 - More on Accidental Hypothermia with Ken Zafren
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Aug 29, 2023 Expert guest discusses accidental hypothermia and the concept of afterdrop. Controversy and myths surrounding rewarming methods are debunked. Proper management of mildly hypothermic patients and avoiding common mistakes are highlighted. Considerations for hypothermia patients and invasive rewarming strategies are discussed.
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Afterdrop Explained
- Afterdrop, a continued core temperature drop after removing a hypothermic person from the cold, has two causes.
- The less important cause is the body's cold mass cooling the core; the more important is cold blood returning from the extremities.
Rewarming a Hypothermic Patient
- Rewarming the whole patient, ideally with forced air warming, is generally the best approach in the field.
- Avoid rewarming extremities first, as it sends cold blood to the core, increasing ventricular fibrillation risk.
Managing Mild Hypothermia
- For mildly hypothermic, alert patients, allow them to rest, sit up gradually, and give them warm, caloric fluids.
- Avoid making them walk, as this can trigger serious afterdrop and rescue collapse.